Efficacy of Eggshell Membrane in Knee Osteoarthritis: A Systematic Review and Meta-Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Eligibility Criteria
- (a)
- Studies that combined eggshell membrane with other nutraceuticals;
- (b)
- Studies lacking necessary quantitative data for the meta-analysis, such as means and standard deviations of the measured outcomes;
- (c)
- Studies without a control group;
- (d)
- Studies where patients did not have knee joint pain or were not diagnosed with osteoarthritis;
- (e)
- Non-original articles such as case reports, editorials, opinion pieces, and reviews; and
- (f)
- Duplicate studies, referring to multiple publications reporting on the same study or patient cohort.
2.2. Information Sources and Search Strategy
2.3. Selection Process
2.4. Data Items and Quality Assessment
2.5. Synthesis Methods
3. Results
3.1. Study Selection
3.2. Study Characteristics
3.3. Risk of Bias in Included Studies
3.4. Effects of the Intervention
3.5. Publication Bias
4. Discussion
Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
References
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Authors | Country | N | Women n (%) | Age (Years) | BMI kg/m2 | Design RCT | Dosage (mg) | Duration | Disease Severity | Outcome | Results | Conclusions |
---|---|---|---|---|---|---|---|---|---|---|---|---|
Cánovas et al. (2022) [19] | Spain | HD = 25 LD = 24 CG = 26 | 52.0 | 38.4 | 25.1 | Double blind, parallel | HD = 500 LD = 300 | 8 weeks | ACR functional grades I-III | WOMAC and VAS | For VAS scale, all groups showed a statistically significant decrease in pain perception at the end of the study. In particular, the high-dose group showed a statistically significant reduction in pain compared to the control group. Regarding the WOMAC results, all groups showed a significant decrease in the WOMAC score, indicating an improvement in functional capacity and quality of life. | Eggshell membrane effectively reduced knee pain and stiffness in osteoarthritis patients, with the response being dose dependent. |
Eskiyurt et al. (2019) [34] | Turkey | IG = 81 CG = 80 | 83.8 | 57.2 | 29.5 | Double blind, crossover | 500 | 90 days | Kellgren-Lawrence grade 2 and 3 | WOMAC | Significant improvements in WOMAC scores (pain, stiffness, function) were observed in the NEM group within 7 to 30 days. The percentage of subjects experiencing greater decreases in WOMAC—pain score was significantly higher in the 90-day NEM group compared to the 60-day group. After 90 days, the original placebo group showed marked clinical improvement upon addition of NEM, resulting in no significant difference in WOMAC scores compared to the original NEM group. | NEM was effective in providing rapid and persistent clinically meaningful improvements in the WOMAC scores for subjects with moderate-to-severe osteoarthritis of the knee. The study also confirmed that NEM was safe and well tolerated, with no occurrence of serious adverse events. |
Hewlings et al. (2019) [20] | USA | IG = 41 CG = 43 | 72.0 | 53.3 | 28.2 | Double blind, parallel | 450 | 84 days | ACR criteria (minimum 3 criteria) | WOMAC | The change in the composite WOMAC score was statistically different from baseline in the Study Product cohort at all subsequent visits, 3 (day 5), 4 (day 28), 5 (day 57), and 6 (day 86) by t-test. The mean change from baseline in the Placebo cohort was not statistically different from baseline in visit 3 (day 5). It was statistically different from baseline in visits 4 (day 28), 5 (day 57), and 6 (day 86) by t-test. | The study concluded that the consumption of eggshell membrane showed significant improvement in physical performance, mobility, and joint stiffness within 5 days when compared with a placebo. These improvements were maintained over the 12-week study period. The study also confirmed the safety of product, with no observed human safety concerns. |
Ruff et al. (2009) [21] | USA | IG = 29 CG = 31 | NR | NR | NR | Double blind, parallel | 500 | 60 days | ACR functional grades I–III | WOMAC | The study found that NEM® supplementation significantly improved pain and stiffness scores compared to placebo at all time points. Rapid improvements were observed within just 10 days of supplementation. While function and overall WOMAC scores also showed improvement, these did not reach statistical significance. The beneficial effects on pain and stiffness were maintained or further improved at the 60-day mark. | The conclusions of the study suggest that eggshell membrane supplementation could be an effective and safe option for the relief of discomfort and inflexibility associated with knee osteoarthritis. The supplement was found to provide rapid relief, with significant improvements observed as early as 10 days after the start of the treatment. |
Kiers and Bult (2021) [15] | Netherlands | IG = 75 CG = 75 | 53.3 | 63.4 | NR | Double blind, parallel | 300 | 84 days | Positive OA diagnosis with self-reported knee pain score ≥ 3 and <9 | KOOS and NSR-P | KOOS scores were similar for both the eggshell membrane and placebo groups at the start of the study. However, the effect was significant for two of the five KOOS category scores, namely “Pain” and “Daily Life” functioning, showing long-lasting improvement of 5–8 points on a 0–100 scale of complaint categories. The pain relief effects maximized after 3 weeks and decreased only slightly until measurements finished in week 12. NRS-P scores decreased at a similar rate for both groups during the first six weeks of treatment. | The study concludes that the eggshell membrane extract appears to be effective in alleviating pain and improving daily life functioning in individuals with knee osteoarthritis. The beneficial effects were observed across multiple categories of KOOS scale, indicating a potential for broad impact on quality of life. However, these effects were not mirrored in the results from NRS-P, suggesting that the specific benefits of eggshell membrane may be more nuanced than general pain relief. |
Jensen et al. (2015) [35] | USA | IG = 13 CG = 12 | 63.0 | 52.5 | 30.0 | Double blind, crossover | 450 | 4 weeks | Mild to moderate physical limitations | VAS | Participants who had been experiencing chronic pain in their knees (among other joints) for at least 6 months reported significant improvements in their condition after consuming water-soluble eggshell membrane. This suggests that water-soluble eggshell membrane may be beneficial in reducing knee pain in individuals with chronic joint conditions. | The consumption of water-soluble egg membrane was associated with significant improvements in joint function, comfort during daily activities, and increased physical activity. Notably, significant improvements in the range of motion were observed for the neck, shoulders, back, hips, knees, and ankles during water-soluble egg membrane consumption compared to placebo. |
Casado-Santos et al. (2024) [36] | Spain | IG = 19 CG = 18 | 56.0 | 51.4 | 29.4 | Double blind, parallel | 300 | 60 days | Positive OA diagnosis with symptoms of pain, stiffness, or functionality problems | WOMAC | The RM-ANOVA analysis of variance showed a significant overall improvement in patients treated with MKARE®, and ESM-RT compared to day 0 in both 30- and 60-days timespans. | MKARE® effectively reduced knee pain and improved physical function in osteoarthritis patients, with significant improvements observed over the 60-day study period. |
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García-Muñoz, A.M.; Abellán-Ruiz, M.S.; García-Guillén, A.I.; Victoria-Montesinos, D. Efficacy of Eggshell Membrane in Knee Osteoarthritis: A Systematic Review and Meta-Analysis. Nutrients 2024, 16, 2640. https://doi.org/10.3390/nu16162640
García-Muñoz AM, Abellán-Ruiz MS, García-Guillén AI, Victoria-Montesinos D. Efficacy of Eggshell Membrane in Knee Osteoarthritis: A Systematic Review and Meta-Analysis. Nutrients. 2024; 16(16):2640. https://doi.org/10.3390/nu16162640
Chicago/Turabian StyleGarcía-Muñoz, Ana María, María Salud Abellán-Ruiz, Ana Isabel García-Guillén, and Desirée Victoria-Montesinos. 2024. "Efficacy of Eggshell Membrane in Knee Osteoarthritis: A Systematic Review and Meta-Analysis" Nutrients 16, no. 16: 2640. https://doi.org/10.3390/nu16162640
APA StyleGarcía-Muñoz, A. M., Abellán-Ruiz, M. S., García-Guillén, A. I., & Victoria-Montesinos, D. (2024). Efficacy of Eggshell Membrane in Knee Osteoarthritis: A Systematic Review and Meta-Analysis. Nutrients, 16(16), 2640. https://doi.org/10.3390/nu16162640